Changes in financial well-being and memory function and decline in middle-aged and older adults.

Many older adults experience financial insecurity. While prior studies link lower later-life SES, financial stress, and financial shocks to worse cognitive outcomes, limited research has examined how dynamic changes in financial well-being-a multidimensional measure of financial circumstances-influence cognitive aging. Here, we examined associations between changes in financial well-being and memory outcomes among 7676 adults aged 50+ in the Health and Retirement Study ("HRS," 2010-2020). We developed and validated an 8-item index of poor financial well-being using existing HRS survey items aligned with domains from the Consumer Financial Protection Bureau's Financial Well-Being Scale. In confounder-adjusted linear mixed-effects models, we estimated associations of average financial well-being and significant improvements or worsening in financial well-being over four years with changes in memory z-scores calculated biennially from 2016-2020. Each 1-point worsening in average financial well-being was associated with poorer memory function (β = -0.009 SD, 95% CI, -0.020 to 0.003) and accelerated decline (β = -0.007 SD/year, 95% CI, -0.010 to -0.003). Associations were largest for participants with significant worsening of financial well-being and for those aged ≥65 at baseline. Results were robust to sensitivity analyses addressing potential reverse causation and attrition. These findings suggest that midlife and later-life declines in financial well-being may contribute to accelerated cognitive aging.